ch 22 Ethics and Values in Nursing Practice

What are morals in the context of healthcare ethics?

Judgments about behavior based on specific beliefs that form accepted standards of right and wrong.

What is a value?

A deeply held belief about the worth of an idea, attitude, custom, or object that influences choices and behaviors.

What is bioethics?

The study of ethical issues and decisions arising within healthcare, medicine, and the biological sciences.

What does the ethical principle of autonomy refer to in healthcare?

Respecting a patient's right and freedom to make independent decisions regarding their own medical care.

What is beneficence in healthcare ethics?

Taking positive actions to help others and actively promote the best interests of the patient.

What is nonmaleficence in healthcare ethics?

The fundamental obligation to do no harm and to avoid causing hurt or injury to patients.

What does justice signify in health ethics?

Fairness and equity in the distribution of healthcare resources, treatments, and access.

What is fidelity in nursing ethics?

The agreement to keep promises and maintain faithfulness to commitments made to patients and professional duties.

What is a professional code of ethics?

A set of guiding ethical principles that all members of a profession accept and commit to uphold.

What are the four key principles outlined in the nursing Code of Ethics?

Advocacy, responsibility, accountability, and confidentiality

What does the principle of advocacy require of a nurse?

Supporting and defending the health, safety, patient rights, and well-being of the patient.

What does responsibility entail under the nursing Code of Ethics?

Respecting and carrying out professional duties and obligations according to established clinical standards.

What is accountability in nursing practice?

Answering for one's own professional choices, clinical actions, and patient outcomes.

What is confidentiality in professional nursing?

Protecting patient privacy by safeguarding personal health information against unauthorized disclosure.

What is the core objective of values clarification in ethical practice?

To distinguish among value, fact, and opinion in order to clarify perspectives and resolve ethical conflicts

To resolve ethical conflicts effectively, what three elements must healthcare professionals distinguish between?

Values, facts, and opinions.

Why is clarifying personal and patient values essential during ethical discourse?

It allows clinicians to recognize personal biases and ensure ethical decision-making remains focused on patient needs.

What is the central premise of deontology?

Actions are right or wrong based on fidelity to moral duties and rules, regardless of the consequences.

What is the foundational measure of morality in utilitarianism?

The usefulness of an action, determined by its capacity to produce the greatest good for the greatest number of people.

How does casuistry resolve ethical dilemmas?

By using case-based reasoning to compare current ethical situations with precedents set by past paradigm cases.

What does feminist ethics focus on in healthcare decision-making?

Analyzing relationships, power imbalances, and the inclusion of marginalized or vulnerable populations.

What does the ethics of care emphasize in nursing?

Prioritizing human relationships, empathy, personal narratives, and caring actions over abstract rules

What constitutes an ethical dilemma?

A situation involving conflicting moral principles where no single available choice completely fulfills ethical standards

What is moral distress in a clinical setting?

The psychological anguish felt when a clinician knows the right ethical action to take but is blocked by institutional barriers.

How does moral distress differ fundamentally from an ethical dilemma?

In an ethical dilemma, the right action is uncertain; in moral distress, the right action is clear, but institutional obstacles prevent performing it.

What is the main function of an ethics committee in a healthcare facility?

To provide interprofessional ethics consultation, staff education, and institutional policy review

What is Step 1 in processing an ethical problem?

Ask: Is this an ethical problem?

What action defines Step 2 in processing an ethical problem?

Gathering all relevant clinical, social, and spiritual information regarding the case.

What occurs during Step 3 of ethical problem solving?

Identifying the ethical elements within the problem and examining personal and professional values.

What takes place during Step 4 when resolving an ethical issue?

What is Step 5 in the stepwise framework for ethical decision-making?

What is Step 5 in the stepwise framework for ethical decision-making?

Identifying and listing all possible courses of action.

What does Step 6 require in the process of resolving an ethical problem?

Creating, implementing, and carrying out an action plan.

What is the final step (Step 7) in processing an ethical problem?

Evaluating the implemented action plan.

In ethical decision-making, why must information gathering (Step 2) precede problem statement formulation (Step 4)?

Because a comprehensive understanding of clinical facts and contextual data is needed to accurately define the ethical dilemma

Why is social media use a key ethical concern in modern healthcare?

Online posting poses serious risks of violating patient confidentiality and blurring professional boundaries.

What factors are evaluated when assessing quality of life in bioethics

Physical function, emotional state, level of pain, independence, and the patient's subjective appraisal of life's worth.

Which primary ethical conflict frequently arises in end-of-life care decisions?

Balancing autonomy (patient's choice to withhold intervention) against beneficence and nonmaleficence regarding suffering.

Which ethical principle is central to debate regarding universal healthcare access?

Justice, which demands fair and equitable allocation of medical resources.

What is the primary role of the nurse when collaborating to resolve ethical problems?

To articulate a unique perspective built on direct clinical, behavioral, and psychosocial bedside observations.

Honoring an adult patient's informed refusal of medical treatment upholds the ethical principle of _____.

Autonomy

Refusing to administer a medication with an unsafe dosage error adheres to the principle of _____.

Nonmaleficence

Fulfilling a commitment to reassess a patient's pain 30 minutes after medication administration reflects the value of _____.

Fidelity

Assisting a patient with repositioning and range-of-motion exercises to prevent pressure injuries is an instance of _____.

Beneficence

Promptly reporting a nursing medication error to the charge nurse demonstrates professional _____.

Accountability

How does deontology contrast with utilitarianism in moral evaluation?

Deontology assesses whether an act itself is inherently right or wrong, whereas utilitarianism evaluates the act based solely on its outcome.

How does an ethics of care framework contrast with traditional deontological ethics?

Ethics of care focuses on relationships, context, and compassion, whereas deontology relies on strict, universal rule fulfillment.

What systemic condition often gives rise to moral distress in clinical nursing?

Severe understaffing or institutional regulations that compromise the delivery of safe, optimal care.

Why does a patient refusing a life-saving blood transfusion create an ethical dilemma for clinicians?

It places patient autonomy in direct conflict with the clinician's obligation of beneficence.

Which professional fields are typically represented on a hospital ethics committee?

Nurses, physicians, bioethicists, social workers, chaplains, and legal representatives.

What is the correct sequential order of the 7 steps used to resolve an ethical problem?

1. Recognize ethical nature

2. Gather information

3. Identify ethical elements/values

4. Name the problem

5. Identify actions

6. Implement action plan

7. Evaluate plan